| disease | Mental Disorders Associated with Physical Diseases |
| alias | HIV |
Mental disorders due to systemic infections refer to psychiatric disturbances caused by extracranial systemic infections resulting from viruses, bacteria, spirochetes, fungi, parasites, or other microorganisms such as Chinese Taxillus Herb parasites. These infections include sepsis, syphilis, cold-damage disease, macula and papule cold-damage disease, malignant malaria, schistosomiasis, human immunodeficiency virus (HIV) infection, among others. No direct evidence of intracranial infection is found.
bubble_chart Etiology
Disease cause
is triggered by external viruses, bacteria, spirochetes, fungi, protozoa, and Chinese Taxillus Herb parasites invading the body and causing illness.
The mechanism of disease
The occurrence of mental disorders is related to the aforementioned pathogens entering the body and exerting their effects, but other factors are also involved.
The following points are of significant importance:
1. Toxins from viruses and bacteria cause direct damage to brain cells.
2. Increased metabolism due to illness leads to the accumulation of intermediate metabolic products in the brain.
3. Acute infections can cause temporary cerebral edema and cerebral hypoxia.
4. Infections may induce high fever, excessive sweating, and the patient's inability to eat normally, resulting in physical exhaustion, nutritional deficiencies, weakness, insufficient energy supply, as well as acid-base imbalance and electrolyte disturbances, which affect brain function.
5. Individual differences, such as the elderly, children, or those with a previously weak constitution, are more prone to mental disorders during physical infections.
Among the combined effects of the above factors, the nature of the infection (e.g., the affinity of the pathogen for brain cells), severity, speed, quantity of pathogens, duration of action, and the effectiveness of anti-infection measures play a critical role in the occurrence of mental disorders.
bubble_chart DiagnosisThe clinical manifestations of mental disorders caused by infection depend on whether the infection is acute or chronic. Acute infections often lead to acute mental disorders, primarily characterized by disturbances of consciousness, while chronic infections frequently result in chronic mental disorders, such as schizophrenia-like states, depressive states, manic-like states, personality changes, and intellectual impairments.
Mental disorders associated with several common infectious diseases:
(1) Mental disorders caused by epidemic common cold
This is an acute pestilential respiratory disease caused by the influenza virus. Since the influenza virus has a strong affinity for the central nervous system, it often leads to mental disorders. Reports indicate an incidence rate of 25–35%. The main clinical manifestations include prodromal symptoms such as headache, weakness, fatigue, and sleep-wake cycle disturbances. Subsequently, patients may experience drowsiness, perceptual disturbances, and feelings of unreality. During high fever or in severe cases, disturbances of consciousness may occur, such as clouding of consciousness or even delirium. As the condition improves, patients enter the stage of convalescence, during which depressive states and cerebral asthenia syndrome are the primary manifestations. A small number of cases may develop encephalitis symptoms. The illness duration is relatively short, and the prognosis is generally good.
(2) Mental disorders caused by pneumonia
In acute pulmonary infections, disturbances of consciousness, such as confusion or delirium, may occur during the peak of the illness. Chronic pulmonary infections, such as pulmonary subcutaneous nodules, mainly manifest as depressive states accompanied by memory decline, difficulty concentrating, and slowed thinking.
In the common type, during the high fever phase, patients may experience confusion, disorientation, and perceptual disturbances. Malignant malaria, or cerebral malaria, is characterized by highly virulent, neurotropic plasmodia that can cause brain pathologies such as focal necrosis, hemorrhage, and cerebral edema. This occurs in malaria-endemic areas or in patients with poor immunity. Psychiatric symptoms include severe headache accompanied by nausea, vomiting, dysphoria, and restlessness, followed by disturbances of consciousness such as clouding or delirium, or even unconsciousness. At this stage, obvious pathological signs or symptoms such as spasms or paralysis may be detected in the nervous system. Patients appear apathetic. During the stage of convalescence, patients exhibit depressive states or cerebral asthenia syndrome. In severe cases, intellectual impairments may occur in the late stage [third stage].
(4) Mental disorders caused by epidemic hemorrhagic fever
Epidemic hemorrhagic fever is an acute pestilential disease prevalent in autumn and winter. The pathogen is likely a virus, but its mechanism of disease remains unclear. The main manifestations include fever and hemorrhage. Clinically, it is divided into the fever phase, hypotensive phase, oliguric phase, polyuric phase, and stage of convalescence. A study reported that among 173 patients with hemorrhagic fever, 53 (30.6%) exhibited central nervous system symptoms, all of which involved mental disorders. Pathological examinations revealed congestion, vascular dilation, and necrotic foci on the brain surface and within the brain parenchyma. Psychiatric symptoms mostly occur during the hypotensive and oliguric phases, primarily manifesting as drowsiness, delirium, or confusion; or excitement and restlessness, lasting 1–2 weeks. Concurrently, obvious neurological symptoms and pathological signs may appear.
The disease is caused by the rabies virus, which enters the body through bites or scratches from infected dogs or other animals. Negri bodies can be found in the brain parenchyma and basal ganglia. Clinically, it is divided into furious and paralytic types. In the initial stage [first stage], patients experience headache, restlessness, low-grade fever, and abnormal sensations such as pain, itching, or numbness at the healed wound site. After 2–3 days, the furious type manifests as hydrophobia, aerophobia, and photophobia. Water, wind, or light can trigger reflexive throat spasms. Patients exhibit tension, fear, and dysphoria. The condition gradually worsens, with generalized spasms, neck stiffness, increased salivation, high fever, heart failure, and respiratory paralysis. Without treatment, sudden death may occur. The paralytic type primarily manifests as limb paralysis and unconsciousness, leading to death.
(6) Mental disorders caused by Acquired Immune Deficiency Syndrome
Acquired Immune Deficiency Syndrome, also known as acquired immunodeficiency syndrome (AIDS), is caused by human T-lymphotropic virus type III (HTLV-III) or lymphadenopathy-associated virus (LAV). It is primarily transmitted through sexual contact, but can also spread via blood and mother-to-child transmission. If the virus invades the central nervous system, neuropsychiatric symptoms may occur. Approximately 30-40% of AIDS patients develop central nervous system pathological changes, including neuronal loss, brain atrophy, glial nodules, and small focal demyelination. In the initial stage [first stage], patients are often influenced by psychosocial factors and exhibit anxiety or depressive states. As the disease progresses, patients may develop dementia-like symptoms such as forgetfulness, sluggishness, difficulty concentrating, reduced problem-solving ability, reading difficulties, apathy, lack of initiative, and social withdrawal. Physical symptoms include lethargy, anorexia, and diarrhea, leading to significant weight loss. Some patients may experience epileptic seizures, mutism, and unconsciousness. AIDS has now become a global public health concern, and there is currently no effective treatment. Antiviral agents and immune enhancers may be tried. The key lies in promoting scientific knowledge, strictly managing blood products, and maintaining responsible sexual behavior to prioritize prevention.
The diagnostic key points are to confirm the basis of infection.
bubble_chart Treatment Measures
Identify the pathogen and implement systematic, active anti-infection treatment along with integrated Chinese and Western medicine therapy. Supportive treatments include: 1. Ensuring adequate nutrition and hydration, maintaining electrolyte and acid-base balance. 2. Improving cerebral circulation. 3. Promoting the recovery of brain cell function, such as administering energy complex solutions. Based on clinical symptoms, small doses of antipsychotics, antidepressants, and anti-anxiety medications with mild side effects may be given. For cases with impaired consciousness, supportive therapy is the main approach. If significant agitation is present, promethazine injections or oral treatment may be administered as appropriate. Nursing care is crucial, with environmental and psychological support helping to alleviate fear and anxiety in patients. Special attention should be paid to safety measures for patients with impaired consciousness to prevent self-harm, falls, or impulsive accidents. For patients with depressive moods, vigilance against suicide attempts is essential, and preventive measures should be taken.
Depending on the nature of the infection, the severity of the physical illness (grade III), and the effectiveness of treatment.
Differential diagnosis focuses on distinguishing between non-infectious organic psychosis and concurrent functional psychosis.
